Abstract

Objective: The purpose of this study was to assess the level of evidence of the clinical research papers published in the Iberoamerican (RICMA), the European (JHSE) and American (JHSA) Journals of Hand Surgery.

Methods: A total of 932 clinical research papers published between 2005 and 2009 (RICMA 60, JHSE 461, and JHSA 411) were reviewed. Two independent observers classified the level of evidence based on the Oxford International Classification, 5 being the lowest level and 1 the highest level. The observed frequencies of the level of evidence for each journal were compared with the expected frequencies by a chi-square (X2) test for categorical variables with a significance level of 0.05.

Results: More than 80% of the papers in RICMA and JHSE and a 67.6% in the JHSA presented a level of 4. No level 1 or 2 studies were published in RICMA, compared to JHSE (0.9% level 1 and 5.0% level 2) and JHSA (8.3% level 1 and 10% level 2). The percentage of papers with level 3 published in RICMA (16.7%) was higher compared to the JHSE (11.1%) and the JHSA (14.1%). All the results were statistically significant (X2=63.945; p<0.001).

Conclusion: The level of evidencie in clinical resarch related to hand surgery depend on the type of journal, being the higuest level of evidence in papers published in the JHSA, followed by the JHSE and finally, the RICMA.